Multiple short courses of corticosteroids in children

Corticosteroids are adrenal steroid hormones responsible for immune homeostasis, blood pressure regulation, energy and appetite regulation, and suppression of inflammation. Oral corticosteroids ('steroids') are commonly used in children for a number of medical conditions, including asthma, croup, inflammatory bowel disease and nephrotic syndrome. There has been some concern about potential side effects of oral, topical or inhaled steroids, including reduction in growth, weight gain, behavioural changes and immunosuppression resulting in infection.

While many recent studies have assessed individual risks, this article aims to provide an overview of steroid use in common paediatric presentations, highlighting current management and risks associated with recurrent doses of steroids in the paediatric population.

Short courses of oral steroids (less than two weeks) in children are very unlikely to cause long-term side effects in children. Children requiring courses more than two weeks' duration warrant specialist referral and a weaning plan to reduce adrenal suppression and insufficiency.